应用ROC曲线确定产时出血量预测产后出血的最佳临界值

Determination of the Best Cut off Value of the Amount of Intrapartum Hemorrhage in Divining Postpartum Hemorrhage by Receiver Operationg Characteristic(ROC)Curve Analysis

目的探讨经历自然分娩的产妇,通过产时出血量预测产后出血的最佳临界值。方法回顾性纳入2017年1—7月在本院住院分娩并符合纳入排除标准的产妇172例,收集其社会人口学资料及相关临床指标,以临床诊断为产后出血者纳入产后出血组(实验组),其余产妇为对照组,对两组产妇的各项指标进行对比分析,并采用受试者工作特征曲线(ROC曲线)探寻产时出血量预测产后出血的最佳临界值。结果ROC曲线分析显示,产时出血量诊断产后出血的ROC曲线下面积为0.978(P<0.000),最佳临界值为295ml(灵敏度为90.9%,特异度为97.6%)。结论产时出血量临界值的确定可为产妇产后出血的预警提供借鉴意义,值得临床推广应用。

Objective To explore the best cut-off value of the amount of intrapartum hemorrhage predicting postpartum hemorrhage.Methods A retrospective analysis of 172 puerperae who were hospitalized in Lianyungang Maternal and Child Health Hospital from January to July 2017 and met the inclusion criteria was conducted.The patients with postpartum hemorrhage were diagnosed as postpartum hemorrhage,the rest of the women as control group,the socio-demographic data and related clinical indexes in both groups were compared,and using the receiver operating characteristic curve(ROC curve)to explore the best cut-off value of the amount of intrapartum hemorrhage predicting postpartum hemorrhage.Results The ROC curve analysis showed that the area under the ROC curve of the amount of intrapartum hemorrhage during diagnosis of postpartum hemorrhage was 0.978(P<0.000)and the critical value was 295ml.Conclusion The determination of the amount of intrapartum hemorrhage can provide reference for the prevention of falls in stroke patients and is worthy of clinical popularization and application.